Individual
MALYNDA COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
504 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-8210
Mailing address
605 W 8TH ST, TISHOMINGO, OK 73460-1228
(580) 371-8210
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
OK
Enumeration date
02/28/2019
Last updated
02/28/2019
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